Explain how my one monthly chin pimple comes to exist.

January 19, 2016 8:24 PM

I get a pimple on my chin every month just before my period. It's kind of hard. It leaves a dark mark behind, and the back of my head hurts if I touch it(weird, I know!). I know that the basic mechanism is hormones, but I don't understand why these hormones only affect my chin and I don't understand why there's always exactly ONE and never more than one or it never skips a month. Do all my pores get together and vote for one pore to be the host? How does this work?

So yes, hormones, but if my skin is producing pimply-stuff, shouldn't the pimply stuff be all over? There are no chin-specific hormones, are there? Also, even if my chin where feeling extra pimply, how does the pimpliness get concentrated in one particular pore? Why not many smaller or pimples or even similar large ones in the other pores (not that I want that, but I don't see why it doesn't happen)? Does my one pimple suck all the pimpliness out nearby pores and gain its strength that way? Explain.

Tangentially, I suppose I would like to avoid this if I could, but that seems unlikely.

posted by If only I had a penguin... to Health & Fitness (18 answers total)

In terms of avoiding it, you probably can't avoid it, but you can go to the dermatologist and get a cortisone shot for a cystic pimple when it appears. I just had a cystic pimple that was so big that it made my lip swell up and I couldn't talk without pain, and this was a lifesaver. I've only had it done for my very bad cysts, and they disappear entirely within about a day and a half. There is a risk that your skin will depress a bit afterwards; this happened to me once, and it bounced back within a week. YMMV.
posted by sockermom at 8:35 PM on January 19, 2016 [4 favorites]

I can't speak to why, but I also used to get a single chin pimple before my period most (though not all) months. Using a salicylic acid treatment on my chin daily for the week before I'd expect the pimple cut the frequency down drastically - from probably 80% of my cycles to 20% of my cycles. I like the Stridex maximum strength pads in the red box - cheap, effective, not too drying.
posted by insectosaurus at 8:36 PM on January 19, 2016 [1 favorite]

Best answer: Actually, yes, there are chin acne-specific hormones: the ones that fluctuate right before your period :)

Period-related hormones cause acne in the chin, mouth, and /or jawline area. If acne is showing up in locations on the body without also being around the mouth, chin, or jawline, then it’s probably not primarily hormone related.

As to why it's only one, my guess would be that you are not especially prone to hormonal acne, but that you aren't immune to it either. It's also a sign that your hormone changes are fairly consistent each month. For some people it varies wildly, and they will have pimples and bad PMS one month, and nothing the next.

If it bothers you, and spot-treatments aren't working, there are birth control methods that stop your period entirely, which would mean that you won't get pimples causes by the hormone surge that's happening now. To treat the dark marks, which are acne scars, you can use a high concentration vitamin C serum nightly to help them fade.
posted by ananci at 8:49 PM on January 19, 2016 [9 favorites]

I sit here with concealer dabbed on my one, sole, huge and painful monthly period pimple. So you are not alone.
posted by easter queen at 8:57 PM on January 19, 2016

Response by poster: Period-related hormones cause acne in the chin, mouth, and /or jawline area.

Seriously? What's the mechanism here? I mean isn't skin skin? How do cheeks know to ignore that hormone? I wish to know everything.
posted by If only I had a penguin... at 9:01 PM on January 19, 2016 [2 favorites]

Google reappearing zit in the same spot. That might help you understand. You probably damaged it at some point and it just gets reinfected.
posted by discopolo at 9:45 PM on January 19, 2016 [4 favorites]

Best answer: It's not that the cheeks are ignoring the hormone -- it's because the acne is caused by an imbalance of testosterone and estrogen. Higher testosterone in relation to estrogen leads to acne. Your lower face has more testosterone receptors than the rest of your face. Really bad hormonal acne can also present on the shoulders, back, and buttocks for the same reason.

Think about places men grow hair after puberty and as they get older -- these are places your body already has testosterone receptors to govern hair growth patterns and oil production. This is why it's possible for trans men to grow male-patterned face and body hair when receiving testoterone injections: the receptors are already there, they just have to be triggered by a sufficient amount of testosterone to begin growing hair. Obviously the normal hormonal swings that happen before your period aren't enough to create actual hair growth, but this is why people with PCOS (which seriously elevates testosterone) develop thicker facial hair, and sometimes even a more masculine body shape.
posted by ananci at 9:46 PM on January 19, 2016 [81 favorites]

It may be something more like a sebaceous cyst rather than a regular pimple, which would explain the recurrence.
posted by Kimmalah at 2:04 AM on January 20, 2016

I get these too. Not always in the exact same spot, often a little bit to either side of my mouth, below my cheeks, but generally in the chin area. I have one now, awesome. I think of it as a little red dashboard light that clicks on to indicate that time of the month.

My layperson's explanation is that it's the part of my face I touch most often - resting my chin in my hand at work, wearing winter scarves that brush my chin, etc. - so it's the most likely place for unfamiliar bacteria to be introduced. I think ananci's explanation is more accurate, though.
posted by Metroid Baby at 3:37 AM on January 20, 2016

Yeah I have PCOS and before I started oral contraceptive to level out my hormones I would reliably break out in the same areas the week before my period, typically the chin and the jaw line, but also my back. I almost always had a big painful honker right in my chin that felt connected to my BONES during the months I didn't ovulate (when my testosterone was elevated abnormally). So basically what ananci said.
posted by Young Kullervo at 6:13 AM on January 20, 2016

I get cystic acne like OP describes. My dermatologist put me on a six-month course of doxycycline (an antibiotic) and that cleared it up. I haven't been on the doxy for about six months and have yet to get any more of those nasty cysts. Your mileage will obviously vary, but I would schedule a trip to a good dermatologist and see what they have to say.
posted by futureisunwritten at 8:33 AM on January 20, 2016

Yup, I did the whole "get a cortisone shot for a cystic pimple" routine anytime I got one for about three years as well as a course of doxycycline for two years. It was the only solution we could find aside from putting me back on Accutane. Now I have normal, problem-free skin. I also starting taking birth control continuously to avoid the ups and downs associated with my menstrual cycle (I pause to have a period 4 times a year) and I think that helped, too. YMMV!
posted by pinetree at 8:40 AM on January 20, 2016

Retin A also helps control cystic acne. It's kind of a skin care wonder drug so if you can get it from your doctor that's a big win.
posted by littlewater at 9:53 AM on January 20, 2016

My friend's dermatologist told her that certain birth control pills are more likely to cause chin acne. Googling it seems to support this.
posted by pseudostrabismus at 10:31 AM on January 20, 2016

Spironolactone was a godsend for my monthly hormonal, PCOS-induced acne.
posted by culfinglin at 3:49 PM on January 20, 2016

Do you maybe rest your chin on your hand there? I get the Period Zits, and realized that the reason I kept getting them in the same spot was because I tend to rest my head on my hand with my fingers right in that spot. So if that spot is already acne-prone, touching it will make it worse.
posted by sarcasticah at 4:17 PM on January 20, 2016 [1 favorite]

Whatever the solution, this is a totally reasonable thing to talk to a dermatologist about (if you are insured). Yeah, you feel dumb going to a doctor for one zit, but as you can see, they have a bevy of tools at their disposal and they won't guilt you about it.
posted by maryr at 7:55 AM on January 21, 2016

Response by poster: Thanks everyone. I have excellent insurance, but really I was more curious than bothered. It's not something I'm willing to go to much trouble to do anything about. I might get some salycilic acid pads or vitamine C cream, but injections seem like more trouble than they're worth.

Interestingly, I was going to argue "but men grow beards on their cheeks, too, so why aren't there testosterone receptors there" but then I googled image searched it and it does seem like beards are primarily along the jawline and really don't go that far up. I never really noticed that before.
posted by If only I had a penguin... at 8:19 AM on January 21, 2016